AJOB Empirical Bioethics

VOL. 7 No. 4 | November 2016

08/11/2011

When a reproductive oncologist in our clinical ethics certificate program did a presentation on drug shortages in oncology last month, I thought perhaps this was just a highly specialized problem. When a few days ago I read Zeke Emanuel’s piece in the NYT about how we are “shortchanging cancer patients”, I began to think that this may just be an oncologist problem.

But when I read today on the WSJ Health Blog that nearly 200 drugs are unavailable or in short supply around the US, I began to wonder why there hasnt been significant public outcry about this. Treatment regimens are being cancelled; important procedures delayed because there simply isn’t enough drug to go around.

And now, the shortage isn’t just a problem for people patients, but pet patients too. Many drugs prescribed by veterinarians are off-label uses of FDA-approved people drugs meaning that when they are in short supply pets are unlikely to get them at all. Moreover, the unpredictability in the availability of these drugs means that when they do sporadically become available the cost can increase two or three times the normal price for the drug. Often when drugs are found, they are stockpiled and hoarded out of fear that they will not be available again. Doctors and patients have been reported doing this.

Although these shortages have been described as “unprecedented” and “horrible”, no one can assure us that the days of drug shortages are going to end any time soon. Upstream intervention and monitoring to ensure these shortages don’t happen again is essential. No one should have to stop their chemotherapy or postpone medical care simply because drug manufacturers cannot adequately forecast either the supply or demand side of the curve.